经阴道彩色多普勒检查结合卵泡刺激激素水平预测卵巢储备功能的初步研究

目的探讨经阴道彩色多普勒超声结合卵泡刺激激素对不孕症患者卵巢储备功能的预测价值。方法纳入不孕症患者30例(不孕组)和健康妇女31例(健康对照组),于月经周期第3天检测受试者血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)水平,运用彩色超声测量窦卵泡计数(AFC)、卵巢间质动脉峰值流速(PSV)、阻力指数(RI)、搏动指数(PI),并进行比较分析。结果不孕组的FSH、LH、PI和RI均显著高于健康对照组(P<0.05,P<0.01),E_2水平、AFC和PSV均低于健康对照组(P<0.05或P<0.01);FSH与LH、PI呈正相关(r=0.436,P<0.01;r=0.472,P<0.05);PSV与FSH、LH呈负相关(r=-5.75,r=-6.26,P<0.01);AFC与FSH呈负相关(r=-0.703,P<0.01)。结论 FSH、AFC和PSV值与卵巢储备功能密切相关,超声技术结合卵泡刺激激素水平能更好地预测卵巢的储备功能。

Study of ultrasound measures and follicle stimulating hormone in prediction of ovarian reserve

Objective To investigate the ability to predict the ovarian reserve function by ultrasound measures and follicle stimulating hormone （FSH）. Methods On the day 3 of a spontaneous cycle, serum levels of follicle stimulating hormone （FSH）, luteinizing hormone （LH） and estradiol （E2 ） were measured, ovarian antral follicle count （AFC） , peak systolic velocity （PSV） , resistive index （RI） and pulsate index （PI） were determined by transvaginal color Doppler. Results The result showed that the FSH, LH, RI and PI of the infertile group were significantly higher than those of the control group, but the level of E2 ,AFC and PSV were significantly lower. FSH positively related with LH and PI（ r =0.436, P 〈0. 01 ; r = 0. 472, P 〈 0.05 ） , PSV was negatively correlated with FSH and LH （ r = -5.75, r = -6.26, P 〈 0.01 ）, AFC was negatively correlated with FSH （ r = - 0. 703, P 〈 0.01 ）. Conclusion The indexes of FSH, AFC and PSV are positively correlated with the ovarian reserve function. Combination of FSH, AFC and FSH is the best predictor of ovarian response.